左肾膀胱重复癌并多囊肾1例报告及文献复习

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1、左肾膀胱重复癌并多囊肾1例报告及文献复习遵义医学院附属医院贵州遵义市563003【摘要】目的探讨肾膀胱重复癌并多囊肾的诊治策略和程序。方法分析1例我院经治的肾、膀胱重癌并多囊肾临床特点、诊断及治疗过程，结合文献报道，总结类似病例的诊治经验。结果木病完成术前评估后行开放性左肾部分切除术,术后病理诊断为多房性肾细胞癌，监测肾功能Creal24umol/Lo2周后恢复良好，行根治性膀胱全切+回肠袋膀胱术，病理诊断为膀胱浸润性尿路上皮癌2级，肿瘤组织累及浅肌层；术后患者新膀胱腹壁造痿口愈合良好，拔出双侧输尿管

2、支架管后无腰痛、发热等不适。患者膀胱癌手术后10天出院。结论肾膀胱重复癌并多囊肾时选择肾部分切除术，若肾功能稳定可二期行膀胱癌手术。【关键词】重复癌；肾癌；膀胱癌；多囊肾【Abstract】ObjectiveToexplorethediagnosisandtreatmentofpoliciesandproceduresofthekidneybladderrepeatedcarcinomawithpolycystickidney.MethodsAnalysisingclinicalcharacteris

3、tics,diagnosisandthetreatmentprocessof1casekidneybladderrepeatedcarcinomawithpolycystickidneycuredinourhospital,onthebasisoftheliterature,sumuptheexperiencesofdiagnosisandtreatmentofsimilarcases.ResultWewouldopenpartialresectionofleftkidneyaftercompleti

4、ngpreoperativeassessment.PostoperativepathologicaldiagnosisshowedtheMultilocularrenalcellcarcinoma,postoperativekidneyCreawas124umol/L.Thepatientrecoveredwellaftertwoweeks,performingradicalbladderfullcutilealpouchbladdersurgery.Postoperativepathological

5、diagnosisshowedinvasivebladderurothelialcarcinoma,whichshowedthemusculartumorinvolvingtheshallow.Postoperatively,thenewbladderabdominalfistulahealedwell,andafterpullingoutbilateralureteralstentpatientshadnolowbackpain，feveranddiscomfort.Patientsdischarg

6、edfromhospitaltendaysafterthecompletionofbladdercancersurgery.ConsiderationThepatientssufferingfromthekidneybladderrepeatedcarcinomawithpolycystickidneycouldchoosetherenalresection，ifrenalfunctionisstable,whocanchoosesecondstagebladdercancersurgery.【Key

7、words]Repeatedcarcinoma；Kidneycancer；Bladdercancer；Polycystickidney同一机体同时或先后发生的两种或两种以上的恶性肿瘤，并可排除复发或转移者称为重复癌[1-9]o临床上肾膀胱重复癌少见，现报告1例单侧肾细胞癌及膀胱移行细胞癌合并多囊肾病史特点、诊治过程及转归情况，结合文献对相似疾病的诊治进行总结。一、临床资料患者男性，67岁，因“间断无痛性肉眼血尿伴左侧腰痛8月”入院。10月前行左肾结石PCNL术，有多囊肾家族病史。查体：双肾区叩击痛，左

8、侧明显，膀胱区稍压痛。泌尿系USB：双肾结石并左肾积水，膀胱占位性病变。腹部CT：膀胱癌、左肾癌，双肾多发囊肿；肝内多发囊肿。膀胱镜：颈口12、3、7点肿瘤侵犯，顶、后壁多发珊瑚样赘生物，最大约2cm×1.5cm；组织活检:（膀胱）低级别浸润性尿路上皮癌。肾功能：Creall7mmol/L0术前CT及病理结果见附图1.附图11-A左肾癌CT表现1・B膀胱癌CT表现1-C膀胱癌术前活检二、诊疗经过结合患者有多囊肾家族史、左肾PCNL史及CT、膀